Mental health of the chronically sick

It is well established that people with long-term conditions such as diabetes or heart disease have higher rates of mental health problems (Chronic illness 'fuels hidden suicide trend', 23 August). There is a close relationship between mental and physical ill health, with cause and effect running in both directions. This is the subject of ongoing research at the King's Fund. However, health services are not always well equipped to deal with the twin needs of this group of people. Evidence increasingly shows that if we were to support the psychological and mental health needs of people with long-term conditions better, this could help them manage their physical illnesses more effectively. And, in turn, could also lead to a reduction in the cost of care.

The government's mental health strategy, released earlier in the year, acknowledged the need to improve the physical health of people with mental health problems as part of their overall treatment. It is important that the forthcoming suicide prevention strategy also contains a focus on supporting people with long-term conditions who become depressed, anxious or develop other mental health problems.

• It is tragic that for some 400 people a year the challenge of serious illness becomes so severe that ending life is preferable. However, the fact that a much larger number of severely ill people carry on "coping" is a reminder of the extraordinary human capacity for resilience. It is also testament to the support provided by family, friends and carers. When the struggle becomes too much to bear, a stigma-free word like dignicide would give recognition to the conscious and courageous decision being taken and would lessen for loved ones the sense of failure suicide often prompts.